October 31, 2013

A fasting glucose target of 90 mg/dL may be linked to a lower risk for macrosomia and other outcomes in women with gestational diabetes, according to researchers.

They included 34 studies that enrolled 9,433 women. The researchers performed a database search of Medline, Embase, Cochrane Library, Web of Science, Scopus, PsycInfo, and Cinahl through May 2011 for randomized trials and observational studies that included women with diabetes during pregnancy and reported planned or achieved glucose targets.

Although the studies appeared to have moderate-to-high risk for bias, a fasting glucose target of 90 mg/dL was the most commonly reported target and the one most strongly related to a reduced risk for macrosomia (OR=0.53; 95% CI, 0.31-0.9) for women with gestational diabetes during the third trimester, according to data.

“All the other measures did not show a statistically significant association for any of the analyzed cutoff points,” researchers wrote.

Unadjusted analyses showed that the fasting blood glucose target of 90 mg/dL was associated with the most reduction in the risk for macrosomia (OR=0.39; 95% CI, 0.29-0.52), large for gestational age (OR=0.68; 95% CI, 0.53-0.88), neonatal hypoglycemia (OR=0.65; 95% CI, 0.49-0.85), hyperbilirubinemia (OR=0.63; 95% CI, 0.43-0.9), and preeclampsia (OR=0.47; 95% CI, 0.31-0.72) in the third trimester, according to data.

“Future observational research must evaluate the role of obesity in the incidence of fetal maternal outcomes in women with and without gestational diabetes,” researchers wrote.